ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 349
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Navigating the grey zone in the response to child abuse and
neglect in primary healthcare settings
Miss Jacqueline Kuruppu1, Cathy Humphreys1, Gemma McKibbin1, Prof Kelsey Hegarty1,2
1
The University of Melbourne, 2The Royal Women’s Hospital
Background
Child abuse and neglect (child abuse) is a common issue that leads to significant health issues. Given
the association between child abuse and health, mandatory reporting laws for doctors and nurses
were introduced in jurisdictions such as the US and Australia. However, this legislation is not globally
or nationally consistent. Thus, there is confusion surrounding the definition of abuse that should be
reported and how to respond when suspicion does not meet the threshold of Child Protection. It is
unclear as to how health professionals navigate the response to child abuse in light of this confusion.
Aim of the study
To explore how Australian GPs and nurses navigate their response to child abuse and neglect in
primary care.
Content
Twenty-two GPs and eight nurses were sampled from private general practice and community health
clinics and Doctors in Secondary Schools, an initiative in the Australian state of Victoria that places
GPs and nurses in high schools. Twenty-six in-depth individual and group interviews were conducted.
The interviews were analysed thematically.
Principal results
We generated three themes: negotiating the threshold; mismatching expectations; and practising in
the grey area. Participants engaged in a process of negotiating between their immediate colleagues,
with families and with statutory Child Protection authorities. When participants decided to make a
report, they were met with a response from Child Protection that did not match their expectations.
This led to feelings of distrust directed towards Child Protection authorities, which left participants
to manage patients within a ‘grey zone’. While practising in the grey zone, participants attempted to
create an emotionally safe space for patients and engage in practical strategies that responded to
patient vulnerabilities.
Goals
• To describe the ‘grey zone’ in relation to clinical practice
• To encourage GPs and nurses to critically reflect on their response to child abuse.
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